Impacts, Learner Diversity, and Curricular Framework of a Virtual Global Health Elective Catalyzed by the COVID-19 Pandemic.

Background: Place-based international electives that build global health competencies have existed for decades. However, these electives require travel and are infeasible for many trainees around the world, particularly those with insufficient financial resources, logistical complexities, or visa limitations. The emergence of virtual approaches to global health electives, catalyzed by the travel pause related to the COVID-19 pandemic, necessitates the exploration of learner impacts, participant diversity, and curricular frameworks. Child Family Health International (CFHI), a non-profit global health education organization that partners with universities to expand immersive educational offerings, launched a virtual global health elective in 2021. The elective drew on faculty from Bolivia, Ecuador, Ghana, Mexico, the Philippines, Uganda, and the United States. Objective: This study aimed to describe a newly developed virtual global health elective curriculum and evaluate the demographics of and impacts on trainee participants. Methods: Eighty-two trainees who were enrolled in the virtual global health elective from January to May 2021 completed both 1) pre- and post-elective self-assessments of domains of competency mapped to the elective curriculum and 2) free text responses to standardized questions. Data were analyzed through descriptive statistical analysis, paired t-testing, and qualitative thematic analysis. Findings: The virtual global health elective had 40% of its participants hail from countries other than the United States. Self-reported competency in global health broadly, planetary health, low resource clinical reasoning, and overall composite competency significantly increased. Qualitative analysis revealed learner development in health systems, social determinants of health, critical thinking, planetary health, cultural humility, and professional practice. Conclusion: Virtual global health electives effectively develop key competencies in global health. This virtual elective had a 40-fold increase in the proportion of trainees from outside the United States, compared to pre-pandemic place-based electives. The virtual platform facilitates accessibility for learners from a variety of health professions and a wide range of geographic and socioeconomic environments. Further research is needed to confirm and expand on self-reported data, and to pursue approaches to greater diversity, equity, and inclusion in virtual frameworks.

Current Healthcare Systems in Light of Hyperendemic NCDs and the COVID-19 Pandemic: Time to Change.

Despite the significant achievements of current healthcare systems (CHCSs) in curing or treating several acute conditions, there has been far less success coping with noncommunicable diseases (NCDs), which have complex roots and nonconventional transmission vectors. Owing to the impact of the invisible hyperendemic NCDs and the COVID-19 pandemic, the limitations of CHCSs have been exposed. In contrast, the advent of omics-based technologies and big data science has raised global hope of curing or treating NCDs and improving overall healthcare outcomes. However, challenges related to their use and effectiveness must be addressed. Additionally, while such advancements intend to improve quality of life, they can also contribute the ever-increasing health disparity among vulnerable populations, such as low/middle-income populations, poorly educated people, gender-based violence victims, and minority and indigenous peoples, to name a few. Among five health determinants, the contribution of medical care to individual health does not exceed 11%. Therefore, it is time to implement a new well-being-oriented system complementary or parallel to CHCSs that incorporates all five health determinants to tackle NCDs and unforeseen diseases of the future, as well as to promote cost-effective, accessible, and sustainable healthy lifestyle choices that can reduce the current level of healthcare inequity.

New Ways to Protect the Host from SARS-CoV-2? Lung Microbiome Metabolites Inhibit STAT3 and Modulate the Immunological Network.

COVID-19 caused by the SARS-CoV-2 infection is a systemic disease that affects multiple organs, biological pathways, and cell types. A systems biology approach would benefit the study of COVID-19 in the pandemic as well as the endemic state. Notably, patients with COVID-19 have dysbiosis of lung microbiota whose functional relevance to the host is largely unknown. We carried out a systems biology investigation of the impact of lung microbiome-derived metabolites on host immune system during COVID-19. RNAseq was performed to identify the host-specific pro- and anti-inflammatory differentially expressed genes (DEGs) in bronchial epithelium and alveolar cells during SARS-CoV-2 infection. The overlapping DEGs were harnessed to construct an immune network while their key transcriptional regulator was deciphered. We identified 68 overlapping genes from both cell types to construct the immune network, and Signal Transducer and Activator of Transcription 3 (STAT3) was found to regulate the majority of the network proteins. Furthermore, thymidine diphosphate produced from the lung microbiome had the highest affinity with STAT3 (-6.349 kcal/mol) than the known STAT3 inhibitors (n = 410), with an affinity ranging from -5.39 to 1.31 kcal/mol. In addition, the molecular dynamic studies showed distinguishable changes in the behavior of the STAT3 complex when compared with free STAT3. Overall, our results provide new observations on the importance of lung microbiome metabolites that regulate the host immune system in patients with COVID-19, and may open up new avenues for preventive medicine and therapeutics innovation.

The role of the university in recovering from COVID-19 and preparing for future crises-perspectives and experiences from Sunway University, Malaysia.

This article is part of the Research Topic 'Health Systems Recovery in the Context of COVID-19 and Protracted Conflict'. Universities, as engines of knowledge creation and dissemination and as incubators of disciplined yet original thinking, have a key role to play in tackling the most complex challenges that societies and our planet face, from infectious diseases to the climate emergency. This commentary presents the perspectives from Sunway University, a young private university in Malaysia that made a strong commitment to the sustainable development goals (SDGs) prior to the pandemic, and its experiences in promoting research, innovation, and learning as part of COVID-19 recovery and in preparation for future crises such as the climate emergency. Some of the university's initiatives include embracing the planetary health approach, reviving essential public health functions, exploring pandemic resilience, addressing 'infodemics' and promoting science diplomacy. The example of Sunway University provides some insights on the opportunities and challenges that academic institutions face as they seek to reorient the paradigm of education, research, and service away from disciplinary siloes and towards a more integrated, preventive, accessible and translational approach.

The Founder: Dispositional Greed, Showbiz, and the Commercial Determinants of Health.

Marketing unhealthy products by multinational corporations has caused considerable harm to individual health, collective wellbeing, and environmental sustainability. This is a growing threat to all societies and a significant contributor to the rising global burden of non-communicable diseases and early mortality. While there is growing consideration of the commercial determinants of health, this is largely focused on the methods by which unhealthy products are marketed and disseminated, including efforts to manipulate policy. Little attention has been paid to the underlying psychological traits and worldviews that are driving corporate greed. Here, we consider the role of "dispositional greed" in the commercial determinants of health with a focus on the historical attitudes and culture in the ultra-processed food industry-exemplified by "The Founder" of the McDonald's franchise. We argue that greed and associated psychological constructs, such as social dominance orientation and collective narcissism, permeate the commercial determinants of health at a collective level. This includes how a culture of greed within organizations, and individual dispositional greed, can magnify and cluster at scale, perpetuated by social dominance orientation. We also consider the ways in which "showbiz" marketing specifically targets marginalized populations and vulnerable groups, including children-in ways that are justified, or even celebrated despite clear links to non-communicable diseases and increased mortality. Finally, we consider how greed and exploitative mindsets mirror cultural values and priorities, with trends for increasing collective narcissism at scale, recognizing that many of these attitudes are cultivated in early life. A healthier future will depend on navigating a path that balances material prosperity with physical and spiritual wellbeing. This will require cultural change that places higher value on kindness, reciprocity, and mutualistic values especially in early life, for more equitable flourishing.

Achieving a sustainable food supply, for good health and planetary health, a focus on the international context

Globally, diet quality is poor, with populations failing to adhere to national dietary guidelines.(1) Such failure has been consistently linked with poorer health outcomes.(2) Examples of malnutrition include both under- and over-nutrition, with overweight and obesity now a significant health problem worldwide.(3) Other commonly occurring examples of malnutrition are micronutrient deficiencies with iron, vitamin A and iodine deficiencies being the most frequently occurring globally. These nutritional challenges have been influenced by recent global world events, including the COVID-19 pandemic, the war in Ukraine and the related economic uncertainties;with all of these events influencing food supply and food security. Diet and health status is socio-economically patterned, and such inequalities are likely to have been enhanced as a result of these recent events. In addition to the impact of diet on health outcomes it is increasingly recognised that what we eat, and the resulting food system, has significant environmental or planetary health impacts, and research activity is growing in terms of understanding the detail of these impacts, what changes are required to reduce these impacts and also how the impact of climate change on our food supply can be mitigated. Given the complexity of the interactions between climate change, other world events, food and health, and the different actors and drivers that influence these, a systems thinking approach to capture such complexity is essential.(4) Such an approach will help address the challenges set by the UN 2030 Agenda for Sustainable Development in the form of the Sustainable Development Goals, which are a call to action to end poverty and inequality, protect the planet, and ensure that all people enjoy health, justice and prosperity.(5) Progress against SDGs has been challenging with an ultimate target of 2030. While the scientific uncertainties regarding diet and public and planetary health need to be addressed, equal attention needs to be paid to the structures and systems, as there is a need for multi-level, coherent and sustained structural interventions and policies across the full food system/supply chain to effect behavior change. Such systems-level change must always keep nutritional status, including impact on micronutrient status, in mind. However, benefits to both population and environmental health could be expected from achieving dietary behaviour change towards more sustainable diets.

Interventions to Reduce Risk for Pathogen Spillover and Early Disease Spread to Prevent Outbreaks, Epidemics, and Pandemics.

The pathogens that cause most emerging infectious diseases in humans originate in animals, particularly wildlife, and then spill over into humans. The accelerating frequency with which humans and domestic animals encounter wildlife because of activities such as land-use change, animal husbandry, and markets and trade in live wildlife has created growing opportunities for pathogen spillover. The risk of pathogen spillover and early disease spread among domestic animals and humans, however, can be reduced by stopping the clearing and degradation of tropical and subtropical forests, improving health and economic security of communities living in emerging infectious disease hotspots, enhancing biosecurity in animal husbandry, shutting down or strictly regulating wildlife markets and trade, and expanding pathogen surveillance. We summarize expert opinions on how to implement these goals to prevent outbreaks, epidemics, and pandemics.

Native microbiomes in danger: Could One Health help to cope with this threat to global health

Planetary health faces an emergency associated with global change. Climate change, the increase in world population and urban concentration, the hyperintensification of productive systems, and the associated changes in land use, among other factors, are generating a risky substrate for global health deterioration. The emergence of the coronavirus disease 2019 pandemic is an example of the problems that this situation can provoke. Several researchers and health professionals have addressed the role of microorganisms, particularly bacteria, in promoting global health, mainly in the past decades. However, global change has contributed to the extinction of a wide array of bacterial species and the disruption of microbial communities that support the homeostasis of humans, animals, and the environment. The need to protect the diversity and richness of native microbiomes in biotic and abiotic environments is crucial but has been frequently underestimated. The "One Health" approach, based on integrating traditionally unconnected fields such as human, animal, and environmental health, could provide a helpful framework to face this challenge. Anyway, drastic political decisions will be needed to tackle this global health crisis, in which the preservation of native microbial resources plays a critical role, even in preventing the risk of a new pandemic. This review aims to explain the importance of native microbiomes in biotic and abiotic ecosystems and the need to consider bacterial extinction as a crucial problem that could be addressed under a One Health approachCopyright © Zunino

Community gardens and urban agriculture: Healthy environment/healthy citizens.

Studies are showing that urban community gardening can improve people's psychological and physiological health in myriad ways. Community gardens increase social capital, provide opportunities for altruism, and create accessible and sustainable food sources in urban environments. The purpose of this study was to explore the mental, social, and physical health benefits of participation in an urban community garden in Edmonton, Canada. A focused ethnography was conducted with surveys and semi-structured interviews. Surveys were sent to volunteers and customers of the Green and Gold Garden (GGG). This was followed by focus group interviews with eight volunteers and four customers. The interview format comprised open-ended questions that encouraged participants to share their perceptions of the health and well-being benefits from being at the GGG. Data were coded via inductive coding, and subsequently categorized into themes via an iterative, reflective process. Four health-related themes were generated from thematic analysis: physical health, social health, mental/emotional health, and connection to the global community. Spending time at the GGG improved the respondents' mental health, even during the COVID-19 pandemic, as they reported feelings of altruism, serenity, and connection with nature. Their social health was improved through gathering with other garden members in a sheltered urban green space within the city limits. This study supports the idea that participation in an urban community garden confers health benefits and engenders a greater awareness of, and appreciation for, the local environment and expands one's scope of care to incorporate planetary health.

Evidence of Antimicrobial Resistance in Bats and Its Planetary Health Impact for Surveillance of Zoonotic Spillover Events: A Scoping Review.

As a result of the COVID-19 pandemic, as well as other outbreaks, such as SARS and Ebola, bats are recognized as a critical species for mediating zoonotic infectious disease spillover events. While there is a growing concern of increased antimicrobial resistance (AMR) globally during this pandemic, knowledge of AMR circulating between bats and humans is limited. In this paper, we have reviewed the evidence of AMR in bats and discussed the planetary health aspect of AMR to elucidate how this is associated with the emergence, spread, and persistence of AMR at the human-animal interface. The presence of clinically significant resistant bacteria in bats and wildlife has important implications for zoonotic pandemic surveillance, disease transmission, and treatment modalities. We searched MEDLINE through PubMed and Google Scholar to retrieve relevant studies (n = 38) that provided data on resistant bacteria in bats prior to 30 September 2022. There is substantial variability in the results from studies measuring the prevalence of AMR based on geographic location, bat types, and time. We found all major groups of Gram-positive and Gram-negative bacteria in bats, which are resistant to commonly used antibiotics. The most alarming issue is that recent studies have increasingly identified clinically significant multi-drug resistant bacteria such as Methicillin Resistant Staphylococcus aureus (MRSA), ESBL producing, and Colistin resistant Enterobacterales in samples from bats. This evidence of superbugs abundant in both humans and wild mammals, such as bats, could facilitate a greater understanding of which specific pathways of exposure should be targeted. We believe that these data will also facilitate future pandemic preparedness as well as global AMR containment during pandemic events and beyond.

Health beyond medicine. A planetary theory extension.

In Niklas Luhmann's vision of the modern functionally differentiated society, health presents one of the essential function systems, along with politics, law, economy and science. While he devoted much effort to elaborating the theoretical foundations of the latter function systems, his work on the health system was relatively sparse. This research gap has been rendered particularly acute by the recent COVID-19 crisis. In reconstructing and updating the Luhmannian analysis of this system, this article presents a three-dimensional concept of organic, psychic and social health and highlights the risks raised by a potential overexpansion of the health concept to the planetary level. The most important of these risks is shown to be the potential rise of totalitarian social control that exceeds classical forms of medical social control. The proposed argument not only contributes to the public criticism of the political responses to the COVID-19 crisis but also fills in some missing pieces of Luhmann's seminal elaboration of the health system.

Systems Biology of COVID-19 and Human Diseases: Beyond a Bird's Eye View, and Toward One Health.

As we gaze into the future beyond the current coronavirus disease 2019 (COVID-19) pandemic, there is a need to rethink our priorities in planetary health, research funding, and, importantly, the concepts and unchecked assumptions by which we attempt to understand health and prevent illness. Next-generation quantitative omics technologies promise a more profound and panoptic understanding of the dynamic pathophysiological processes and their aberrations in diverse diseased conditions. Systems biology research is highly relevant for COVID-19, a systemic disease affecting multiple organs and biological pathways. In addition, expanding the concept of health beyond humans so as to capture the importance of ecosystem health and recognizing the interdependence of human, animal, and plant health are enormously relevant and timely in the current historical moment of the pandemic. Notably, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus causing COVID-19, can affect our body clock, and the circadian aspects of this viral infection and host immunity need to be considered for its effective clinical management. Finally, we need to rethink and expand beyond the false binaries such as humans versus nature, and deploy multiomics systems biology research if we intend to design effective, innovative, and socioecological planetary health interventions to prevent future pandemics and ecological crises. We argue here that juxtaposing ecology and human health sciences scholarship is one of the key emerging tenets of 21st-century integrative biology.

Current research and future directions for realizing the ideal One-Health approach: A summary of key-informant interviews in Japan and a literature review.

The COVID-19 pandemic has highlighted the importance of the One Health (OH) approach, which considers the health of humans, animals, and the environment in preventing future pandemics. A wide range of sustainable interdisciplinary collaborations are required to truly fulfill the purpose of the OH approach. It is well-recognized, however, that such collaborations are challenging. In this study, we undertook key-informant interviews with a panel of stakeholders from Japan to identify their perceived needs and challenges related to OH research. This panel included scientists, government officials, journalists, and industry stakeholders. By combining a thematic analysis of these interviews and a literature review, we summarized two key themes pertinent to the effective implementation of OH research: types of required research and systems to support that research. As a technological issue, interviewees suggested the importance of research and development of methodologies that can promote the integration and collaboration of research fields that are currently fragmented. An example of such a methodology would allow researchers to obtain high-resolution metadata (e.g. ecological and wildlife data) with high throughput and then maximize the use of the obtained metadata in research, such as in environmental DNA analysis, database construction, or the use of computational algorithms to find novel viral genomes. In terms of systems surrounding OH research, some interviewees stressed the importance of creating a sustainable research system, such as one that has continuous budget support and allows researchers to pursue their academic careers and interests. These perceptions and challenges held by Japanese stakeholders may be common to others around the world. We hope this review will encourage more researchers and others to work together to create a resilient society against future pandemics.

Aligning conservation and public health goals to tackle unsustainable trade of mammals

Unsustainable wildlife trade is a major driver of biodiversity loss and an important public health threat. Yet, effective wildlife trade regulation is currently at odds with food security and economic incentives provided by this global, multibillion-dollar industry. Given such limitations, public health and conservation resources can be aligned to target species for which trade both increases risk of extinction and threatens public health. Here, we developed a simple conservation and health trade risk (CHT) index (range: 2-50) using a case study of traded mammals based on species' extinction and zoonotic risks, weighed by the extent of their trade. We applied this index to 1161 International Union for the Conservation of Nature-listed terrestrial mammals involved in the wildlife trade to identify 284 high-priority species that scored high in the CHT index (CHT >= 18). Species ranking high for conservation, public health, and trade risks include those belonging to the orders Primates, Cetartiodactyla (even-toed ungulates), Rodentia (rodents), Chiroptera (bats), and Carnivora (carnivores). Of the high-priority species, 33% (n = 95) are country-endemics and may be good candidates for trade regulations and enforcement at national scales. Our study provides a preliminary step in prioritizing species, taxonomic groups, and countries for focused wildlife trade regulation to meet both conservation and public health goals.

On the Road to Net Zero Health Care Systems: Governance for Sustainable Health Care in the United Kingdom and Germany.

Health care lies at the forefront of the impacts of climate change. Since the health sector is a major polluting and emission intensive sector, it remains a crucial challenge to address sustainability. The English National Health System (NHS) aims to be the first in the world to achieve net zero in all emission classes (Scope 1-3). In Germany, sustainability in health care is being driven bottom-up, while the Federal Ministry of Health at the time of the research in early 2021 takes no active stance on a net zero health care system. This article analyses the approaches to sustainability in the two different health care systems, explores common challenges, and draws recommendations to support the transition of the sector to a net zero future. An exploratory mixed method approach was taken applying qualitative and quantitative methods. This includes high-level expert interviews and an online survey from the United Kingdom (UK) and Germany. Results reveal the complex nature of health care systems and the need for engraining a systems-thinking approach. The findings call for the legal embedding of sustainability into the key principles of health care in Germany, endorses the ambition of the national health care systems in the UK, recommends collaborative cross-sector approaches for sustainability, and highlights the need for increased public awareness on the interrelation between human and planetary health to enable governance for sustainable health care.

Critical Success Factors in Combating Dengue and COVID-19: Lessons for Future Pandemics

The COVID-19 pandemic has affected the entire world, causing millions of deaths. In addition to this disease, many countries also periodically face outbreaks of other diseases, such as dengue. Although the two diseases have their specific characteristics, there may be common factors affecting them. Knowing these factors is essential for governments to plan actions to mitigate the impacts of future epidemics. This research aims to analyze data from several dimensions to identify the critical success factors for the fight against dengue and COVID-19. For this, Data Science techniques were applied to data from 645 cities in the State of São Paulo, Brazil. The results provide important information that may explain why some locations have been more successful than others in fighting those diseases, as well as identifying the common factors that may also impact other diseases. © 2022 IEEE.

Greek Students' Planetary Health Profile: A Master's Program in Environmental Communication and Health Promotion

The emergence of Covid-19 demonstrates a breakdown in humanity's relationship with the natural world (Frumkin and Myers, Planetary health: protecting nature to protect ourselves, pp 487–496, 2020). Escaping the “Pandemic Era” will need transformational adjustments and a profound rethinking of our connection with nature (The Lancet Planetary Health, Lancet Planet Health 5(1):E1, 2021;Harris, Participatory media in environmental communication, 2019). Considering how demanding—and at the same time unique this time is- early Anthropocene 2.0 consciousness is a concept worth exploring. Anthropocene 2.0 requires the development of communication skills on issues of environmental and public health concern. Our global health research and training communities and institutions must examine, reflect on, and reform the methods through which we promote and maintain planetary health (Haldane and Berry, The Lancet Planetary Health 5:E10, 2021). Professionals must successfully translate science, convey costs and benefits, and involve stakeholders in pressing environmental issues. Lessons from the pandemic emphasize the significance of systems thinking, the need for collaborative action, and the potential of rapidly changing global behavior. The present Covid-19 “silent period” offered a unique chance to launch a new graduate program in Environmental Communication and Health Promotion at the University of West Attica in Greece. It is critical to know the profile characteristics of those who were selected to attend this graduate program. The pertinent information will give a clear understanding of why people choose the specific field of study. This paper evaluates trainees’ health consciousness, environmental awareness, pro-environmental behavior, environmental activism, and personal values. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

The public health challenge of COVID-19

The world is battling the coronavirus disease 2019 (COVID-19) pandemic. However, pandemics such as COVID-19 are not entirely new phenomena in human history. Humans have always been fighting against infectious diseases since the Neolithic revolution, 12,000 years ago. Over the past few decades, however, new infectious diseases have been caused by sudden environmental changes. To protect against increasing threats from infectious diseases, human society has established public health systems against infectious diseases and has promoted various countermeasures against infectious diseases. In this chapter, past public health efforts in the context of fighting against infectious diseases are described, and the risk factors, such as social and environmental factors, of the burden of the disease are also reviewed. Then, the necessity to make a paradigm shift to a new scientific field, “Planetary Health,” is proposed to achieve a sustainable society after (or with) COVID-19.

Six Pivotal Lessons Learned in South Korea for Whole-of-Government Approach to Successful COVID-19 Vaccine Rollout in Planetary Health.

The COVID-19 pandemic has underscored that systems medicine depends on health systems and services that can respond to planetary health threats in scale and with speed. After 2 years of the pandemic, there are lessons learned in South Korea, from governance to risk communication for planetary health. The learning is timely because COVID-19 likely signals future ecological crises and emerging pathogens amid the climate emergency in the 21st century. By the end of March 2022, South Korea, with a population of 51.6 million, administered more COVID-19 vaccine doses per 100 people than other developed countries, including United Kingdom, Italy, Australia, Israel, Germany, and United States. In South Korea, 233.47 doses of COVID-19 vaccine were administered per 100 people, while Italy (229.48), China (229.39), Australia (217.44), the United Kingdom (211.39), Israel (194.82), and the United States (170.59) fell behind in vaccine rollout. Korea's whole-of-government approach to robust COVID-19 vaccination rollout prompted broad interest in planetary health. Notwithstanding that vaccine rollout is a complex multifactorial outcome, six salient, and often interdependent, factors are identified in this study of South Korea: (1) governance system; (2) logistic capability; (3) delivery strategy and accessibility; (4) established public health infrastructure; (5) risk communication; and (6) public cooperation and engagement. Integration of these factors can create multisectoral synergy to achieve better outcomes in vaccine rollout. The lessons from South Korea can help cultivate planetary health action in other parts of the world during the current COVID-19 pandemic, and in ecological crises in the future.

Tobacco control measures in COVID-19 recovery: an opportune time to restore equity and planetary health.

Tobacco intersects with the COVID-19 pandemic not only in terms of health consequences, but also environmental change and planetary health. Tobacco use exacerbates inequalities, causes catastrophic environmental degradation and climate change and adds burdens to COVID-19-related mortality, which are major challenges to recovery from the COVID-19 pandemic. However, the pandemic has provided a chance to combat tobacco use and accelerate efforts to alleviate these challenges in response. The MPOWER measures introduced by the World Health Organization Framework Convention on Tobacco Control (WHO FCTC) can play a crucial role in COVID-19 recovery to fight tobacco use and contribute to sustainable and equitable development. To accelerate recovery, it is critical to call for actions for governments and policy-makers to strengthen synergies and coordinate policy actions emphasising tobacco control and cessation across equity, public health, and climate actions as global authorities pledge to achieve the Sustainable Development Goals (SDGs) and net zero emissions targets as part of the Climate Change Conference 2021 (COP26).